Pidotimod: the past and the present

Abstract

At the end of 1990s, acute respiratory tract infections (ARTIs) were called the 'forgotten pandemic’, with a clear dichotomy between developing and industrialised countries in mortality and morbidity, the main outcomes associated with ARTIs. This definition still applies 20 years later, when the introduction of new and safe antibiotics and vaccines has certainly contributed to controlling the most life-threatening ARTIs, but has not had a major impact on viral ARTIs in paediatric age. One functional approach to preventing and treating ARTIs is non-specifically increasing the immune response or enhancing the children’s innate defence mechanisms. Different kinds of biologically active substances – called immunostimulants – of natural and synthetic origins and with different mechanisms of action have been introduced in some countries for the prevention of ARTIs in children. Recently, research focused on one of these compounds, Pidotimod, has attempted to better clarify and define its mechanisms of action both in vitro and in vivo. In this paper, we critically examine the most recent findings on Pidotimod. Certainly the improvement of research methodology in the last 20 years and the acquired knowledge in various fields of clinical immunology should be the starting point for research on Pidotimod. Preclinical research will be essential to better understand the mechanisms of action of this compound. However, in vivo studies, especially randomised control trials, will be necessary to establish the real efficacy of Pidotimod in the prevention of ARTIs in paediatric age.

Efficacy of Pidotimod use in treating allergic rhinitis in a pediatric population

“…Pidotimod has shown an excellent profile of tolerability and safety in addition to a significant effectiveness in modulating immune response and in controlling RRI [ 24 – 26 ]. In vivo and in vitro studies showed that Pidotimod could improve immune response, affecting both adaptive both innate immunity.…”

Antibiotic therapy, supportive treatment and management of immunomodulation-inflammation response in community acquired pneumonia: review of recommendations

“… Pidotimod Among immunomodulators, Pidotimod is a synthetic dipeptide molecule endowed with immunomodulatory activity that affects both innate and adaptive immune responses. Previous positive effects on inflammation were obtained in in vitro studies [ 51 , 52 ]; and subsequently in in vivo studies, where the drug reduced the incidence of upper and lower airways symptoms in children [ 53 ], and augmented the influenza specific immune responses in patients with Down syndrome who underwent vaccination [ 54 ]. Lastly, a recent multicenter, interventional, prospective study was conducted on adult patients hospitalized with community acquired pneumonia [ 55 ].…”

Pidotimod: the state of art

“…In the last years different kinds of immunostimulants of natural or synthetic origins and working with different mechanisms have been created for the prevention of ARTIs. Pidotimod (3-L-pyroglutamyl-L-thiaziolidine-4 carboxylic acid) is a synthetic dipeptide molecule with immunomodulatory properties [ 1 ].…”

“…The results show benefits from that therapy in many aspects of respiratory tract infections: a reduction of the number of infections, less day of fever, a lesser severity of signs and symptoms, and consequently a reduction in use of antibiotics and symptomatic drugs. Furthermore, the trials suggest that Pidotimod is a simple, well-tolerated and safe approach to reduce risks and symptoms correlated to respiratory tract infections [ 1 ] (Table 1 ).…”

“…In fact, the immaturity of the immune system in children maintains a considerable role. That’s why a functional approach to preventing and treating ARTIs is increasing the immune response or enhancing the child’s innate defence mechanisms [ 1 ].…”